A pancreatite aguda na visão do imunologista

The acute pancreatitis is an inflammatory process of the pancreas, resulting from the action of enzymes activated inappropriately,causing swelling, bleeding and even pancreatic necrosis and peripancreática. The acinar cells in the pancreas and stellar cellspancreatic has been the study as participants in shaping the inflammatory process along with other inflammatory cells. Severalcytokines are released during pancreatitis, and thus, the local inflammatory process initially, may have an important systemicimpact, and the patient may present hypovolemia, involvement of multiple organs and systems and the possibility of death. Theclinical condition of pancreatitis as mild or severe depends on the length of the process and the complications that may arise.A pancreatite aguda é um processo inflamatório do pâncreas, decorrente da ação de enzimas inadequadamente ativadas,que causam edema, hemorragia e até necrose pancreática e peripancreática. As células acinares presentes no pâncreasassim como as células estelares pancreáticas tem sido alvo de estudo como participantes na formação do processoinflamatório juntamente com outras células inflamatórias. Diversas citocinas são liberadas durante a pancreatite, e assim,o processo inflamatório inicialmente local, pode ter uma repercussão sistêmica importante, e o paciente poderá apresentarhipovolemia, comprometimento de múltiplos órgãos e sistemas e possibilidade de óbito. A condição clinica da pancreatitena forma leve ou grave dependerá da extensão do processo e das complicações que podem advir

An Assessment of the Effectiveness of High Definition Cameras as Remote Monitoring Tools for Dolphin Ecology Studies.

Research involving marine mammals often requires costly field programs. This paper assessed whether the benefits of using cameras outweighs the implications of having personnel performing marine mammal detection in the field. The efficacy of video and still cameras to detect Indo-Pacific bottlenose dolphins (Tursiops aduncus) in the Fremantle Harbour (Western Australia) was evaluated, with consideration on how environmental conditions affect detectability. The cameras were set on a tower in the Fremantle Port channel and videos were perused at 1.75 times the normal speed. Images from the cameras were used to estimate position of dolphins at the water’s surface. Dolphin detections ranged from 5.6 m to 463.3 m for the video camera, and from 10.8 m to 347.8 m for the still camera. Detection range showed to be satisfactory when compared to distances at which dolphins would be detected by field observers. The relative effect of environmental conditions on detectability was considered by fitting a Generalised Estimation Equations (GEEs) model with Beaufort, level of glare and their interactions as predictors and a temporal auto-correlation structure. The best fit model indicated level of glare had an effect, with more intense periods of glare corresponding to lower occurrences of observed dolphins. However this effect was not large (-0.264) and the parameter estimate was associated with a large standard error (0.113).The limited field of view was the main restraint in that cameras can be only applied to detections of animals observed rather than counts of individuals. However, the use of cameras was effective for long term monitoring of occurrence of dolphins, outweighing the costs and reducing the health and safety risks to field personal. This study showed that cameras could be effectively implemented onshore for research such as studying changes in habitat use in response to development and construction activities

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries